Due to cross-reactivity, individuals with HSV-1 infection get a milder form of HSV-2 infection.

MANIFESTATIONS:

Genital Herpes: Primarily HSV-2, but both can infect.

May be associated with fever, malaise, and inguinal lymphadenopathy.

Virus goes up and remains latent in lumbo-sacral ganglia.

Neonatal Herpes: Perinatal transmission of HSV-2, during an active infection, through the birth canal. Outcome can range from subclinical to severe.

Proctitis:

Meningitis:

Whitlow: HSV-1 or HSV-2. Infection of fingers in healthcare personnel or kiddies who suck their thumbs.

TREATMENT:

Idoxuridine: Topical ointment

Ara-A: Older drug inhibits DNA replication, but it's toxic. Used for encephalitis, or topically for keratitis.

IUDR: Acts on DNA replication and is too toxic to use systemically.

Acyclovir: Converted into triphosphate form by viral Thymidine Kinase. It blocks viral DNA polymerase and is virtually non-toxic. It does not cure latent infection but it's great for symptomatic infections.

VARICELLA-ZOSTER VIRUS (HHV-3, VZV):

REPLICATION: Daughter virions remain largely cell-associated.

TRANSMISSION is probably respiratory. Nasal mucosa.

PATHOGENESIS:

Latent Infection: VZV virus remains latent in dorsal root ganglion, where it can later reactivate to form Zoster.

MANIFESTATIONS:

Chicken-Pox (Varicella):

Symptoms: Fever and malaise. Rash starts on trunk and spreads outward to extremities.

In early infection, eosinophilic inclusion bodies are found in nuclei of infected cells.

1 comments:

Anti-viral drugs commonly used to treat CMV retinitis are ganciclovir (Cytovene), foscarnet (Foscavir) and cidofovir (Vistide). These medications can slow down the progression of CMV, but they can't cure it. These potent anti-viral drugs can also cause unpleasant or serious side effects.

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